Why Preventive Care Is Covered Under All Covered California Plans
Did you know one in five Californians qualifies for free or very low cost health insurance? A health insurance plan helps you take advantage of preventive care options that can lower the risk of certain diseases and/or catch others before they become too serious.
Getting preventive care is an important step in staying healthy and avoiding costly healthcare expenses down the line. That’s why you can get preventive care through Covered CA, regardless of which plan you choose. If you’re concerned about whether or not your health insurance policy covers the routine healthcare you need as a California resident, read on to learn all about preventive care and Covered CA plans.
Understanding Preventive Care in Health Insurance
When reading about what your health insurance covers, you’ll probably encounter different categories of support and treatment. For example, plans will have different coverage for prescriptions, physical therapy, emergency and urgent care, and so on. “Preventive and wellness services” is an important category you should understand when signing up for your next policy.
What Is Preventive Care?
As the name implies, it refers to services and treatments that can help prevent future diseases. It usually includes things like screenings, vaccines, and check-ups for certain health conditions.
In the insurance world, preventive healthcare is one of the most common categories of coverage. Many insurers offer several screening services for very cheap or even for free if you go to an in-network doctor. Common examples include blood pressure screening, yearly well-woman exams, and alcohol abuse counseling.
Importance of Preventive Services for Long-Term Health
Getting regular healthcare is one of the best things you can do for your health and well-being, even if you aren’t sick. Doing things to prevent getting sick, such as getting vaccines, can help you reduce future healthcare costs and avoid serious illnesses. In addition, getting regular screenings could help you catch certain issues early, helping you get treatment while it still has the greatest chance of being effective.
The Affordable Care Act and Preventive Care Coverage
The exact coverage you get for screening, testing, and counseling to prevent future issues depends on the type of insurance plan you have. However, thanks to the Affordable Care Act, all marketplace plans need to provide certain essential health benefits, including preventive services.
How the ACA Mandates No-Cost Preventive Services in California
Preventive care is one of the 10 essential health benefits required by the ACA. While coverage can vary for some of the categories, the ACA actually has a list of proactive services that all marketplace plans need to offer at zero cost to you. Even if you have a high copay or deductible, you’ll still be able to get those certain services at no cost to you.
Impact on California Health Plans
Covered California, California’s ACA marketplace, is included in this mandate. So, does Covered California cover annual check-ups and screenings because of ACA? If you sign up for healthcare in California through the marketplace, you’ll be able to get free preventive services in CA, which include many different screenings and examinations.
Preventive Services Covered by Covered California Plans
Wondering exactly which services you can get for free thanks to the preventive care from Covered CA? You can check your summary of benefits for your specific plan for more details, but there’s also a list of services that all ACA insurers must provide for free.
Covered Services for Adults
First, there are services for the general population. In some cases, you have to be at high risk of a certain disease to qualify for screening. In other cases, any adult can get free treatment. Here’s the official list from the ACA for free preventive services from California health plans:
- Abdominal aortic aneurysm screenings
- Screening and counseling for alcohol abuse
- Aspirin and statin medications
- Cholesterol and blood pressure screening
- Colorectal and lung cancer screening
- Depression screening
- Type 2 diabetes screening
- Obesity screening and diet counseling
- STI testing for hepatitis B and C, syphilis, and HIV, STI counseling, and HIV prevention medication
- Fall prevention care
- Immunizations
- Tobacco use screening
- Tuberculosis screening
Some insurers will define preventive health care to include additional services, but they have to include this base list at no cost if you qualify.
Essential Care for Women and Children
There are also certain types of care specifically designed to prevent health issues for women and children. Here is the list for women:
- Breastfeeding counseling and supplies
- Birth control
- Screening for gonorrhea, hepatitis B, syphilis, chlamydia, gonorrhea, and HIV
- UTI screening
- Tobacco counseling
- Rh incompatibility testing
- Maternal depression screening
- Preeclampsia and gestational diabetes screening
- Folic acid supplements
- Screening for gestational diabetes
- Cervical and breast cancer screening
- Bone density testing
- Pap smears
- Diabetes screening
- Domestic violence screening and counseling
It’s especially important for parents to monitor their kids’ health, so there are several services and tests that the ACA covers for children:
- Alcohol, tobacco, and drug screenings
- Autism screening
- Behavioral assessments
- Bilirubin concentration screening
- Blood pressure screening
- Depression screening
- Developmental screening
- Dyslipidemia screening
- PKU screening
- Tuberculin testing
- Fluoride supplements and varnish
- Gonorrhea preventative medication for newborns
- Hearing and vision screening
- Hemoglobin screening
- STI screening, plus HIV prevention medication
- Hypothyroidism screening
- Immunizations
- Lead screening
- Obesity counseling
- Oral health assessments
Some of these services only apply to women and children in certain circumstances, so it’s important to review the exact specifications in your plan.
Accessing Free Care Through Your Plan
To get free services from California health plans, all you have to do is sign up for a marketplace plan during open enrollment. Then, make an appointment with an in-network provider. To double-check, reach out before your appointment to make sure you qualify.
Preventive Care Saves Lives — Find the Right Covered California Plan With Freeway Insurance
Getting early preventive care from Covered CA can make a huge impact on your long-term health. When you can get all kinds of tests and screenings for free, you can take control of your well-being and get essential healthcare as early as possible.
Want to get Covered California preventive care coverage to protect your health? You can sign up today with help from a knowledgeable Freeway Insurance agent. Get started with a phone call to 877-423-1508. You won’t be charged if a Freeway Insurance agent helps you sign up for a health insurance plan – this service is free.
